Diabetes in Children: Giving Insulin Shots to a Child

Introduction

Insulin is available only in an
injectable form that is given into the fatty tissue just under the skin.

If your child doesn't want to feel the insulin needle, your child's doctor can prescribe an indwelling subcutaneous cannula. A small needle is used to insert a soft tube into a place where you give your child an insulin shot, such as the belly. The needle is taken out, but the soft tube (cannula) stays in your child's body and is held in place with tape. Then, when your child needs insulin, the insulin needle is put into the cannula instead of into the skin. This way, your child won't have to feel the insulin needle. The cannula can be used for at least 3 days before your child will need a new one.

The three most important elements of success
in giving insulin injections include:

Making sure you have the right dose of insulin,
especially if you are giving two types of insulin in the same
syringe.

Practicing how to give an injection.

Storing
insulin properly so that each dose will work effectively.

How is insulin prepared and given?

Your doctor or certified diabetes educator (CDE) will
help you and your child learn to prepare and give insulin injections. If your
child is age 10 or older, he or she may be able to give insulin with
supervision. Here are some simple steps to help you and your child learn this
task.

Get ready

To get ready to give an insulin
injection using an insulin vial and insulin syringe or an insulin pen, follow these steps.

Wash your hands with soap and running
water. Dry them thoroughly. If your child is going to help, wash his or her
hands well.

Gather the supplies. Keep the supplies in a bag or kit so your child can carry
the supplies wherever he or she goes.

You will need an
insulin syringe and the vial(s) of insulin, and an alcohol wipe or a cotton ball
dipped in alcohol.

If you are using an insulin pen, you will need a needle that works with your pen. If the pen is reusable, you may need an insulin cartridge. You may also need an alcohol swab.

When an insulin
vial is used for the first time, write the date on the bottle. Insulin stored at room temperature will last for about a month. Read and follow all instructions on the label, including how to store the insulin and how long the insulin will last.

On a reusable insulin pen, note the date you started using the pen. Reusable pens expire (for example, after several years).

Check that a disposable pen's insulin has not expired. This date is usually printed on the pen's label.

Prepare the injection

The preparation will depend
on whether you are giving one type of insulin or mixing two types of insulin in
the injection.

When you are mixing types of insulin to be given in one syringe, follow these precautions.

If you are mixing NPH and short-acting regular insulin, you can use it right away or put it aside to be used
later. Keep it away from heat and light, such as in a refrigerator.

Insulin glargine (Lantus) and insulin detemir (Levemir) cannot be mixed with other types of insulin. They also
cannot be given in a syringe that has been used to give another type of insulin.

If you are using an insulin pen, follow the manufacturer's instructions for attaching the needle, priming the pen, and setting the dose.

Prepare the site

Before giving the injection, take
the time you need to do the following:

Choose where you want to give the injections (injection site). If you give the injections in different places on your
child's body each day (rotate sites), use the same site at the same time of the
day. If your child will be physically active soon after the injection, use a
site that will have the least movement in the activity. The absorption of
insulin is faster in an area that gets movement, which could lead to low blood
sugar. For example, if you give your child an insulin shot right before he or
she plays soccer, give the shot in the belly, rather than in the
leg.

An example of rotating sites:

At breakfast, give the insulin into one
of your child's arms.

At lunch, give the insulin into one of your
child's legs.

At dinner, give the insulin into your child's
belly.

If you use alcohol to clean the
skin before you give the injection, let it dry.

Cleanup and storage

Dispose of the used
syringe, disposable insulin pen, or needle. Do not throw a used syringe, needle, or insulin pen in a trash
can. You can dispose of them in a metal container with a lid that screws on or
that you tape down tightly. You also can buy special containers for disposing
of used needles and syringes. You can buy a small needle clipper device that
breaks the needle off the syringe and stores it safely for disposal. Talk with
your local trash disposal agency, pharmacy, or your doctor about how to get rid of the
container.

Other tips for success and safety

Some tips to help you be safe and successful in
giving your child insulin injections include the following:

You and your child can
practice injecting air or water into an orange until you feel comfortable with the
steps for giving insulin. Then do the steps in front of a doctor or certified diabetes educator and ask him or
her how you did. Practice more if you or your child needs to. If you think that
you can do the task well, give your child a dose of insulin while a doctor
watches. Let your child do this if he or she is ready to try.

Teach other family members how to give insulin
injections. Have at least one other person who can prepare and give your
child's insulin injection in an emergency. It's a good idea to let this person
give your child an injection now and then for practice. Then it will not be as
unfamiliar when an emergency occurs.

Never share syringes with another person because of
the risk of getting diseases that can be transferred through blood, such as
acquired immunodeficiency syndrome (AIDS) or infection of the liver
(hepatitis).

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